Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit

Background: The purpose of this study was to identify trends in survival and chemotherapy use for individuals with smallcell lung cancer (SCLC) in England using the National Lung Cancer Audit (NLCA). Methods: We used data from the NLCA database to identify people with histologically proven SCLC fro...

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Main Authors: Khakwani, Aamir, Rich, Anna L., Tata, Laila J., Powell, Helen A., Stanley, Rosamund A., Baldwin, David R., Hubbard, Richard B.
Format: Article
Published: Public Library of Science 2014
Online Access:https://eprints.nottingham.ac.uk/33745/
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author Khakwani, Aamir
Rich, Anna L.
Tata, Laila J.
Powell, Helen A.
Stanley, Rosamund A.
Baldwin, David R.
Hubbard, Richard B.
author_facet Khakwani, Aamir
Rich, Anna L.
Tata, Laila J.
Powell, Helen A.
Stanley, Rosamund A.
Baldwin, David R.
Hubbard, Richard B.
author_sort Khakwani, Aamir
building Nottingham Research Data Repository
collection Online Access
description Background: The purpose of this study was to identify trends in survival and chemotherapy use for individuals with smallcell lung cancer (SCLC) in England using the National Lung Cancer Audit (NLCA). Methods: We used data from the NLCA database to identify people with histologically proven SCLC from 2004–2011. We calculated the median survival by stage and assessed whether patient characteristics changed over time. We also assessed whether the proportion of patients with records of chemotherapy and/or radiotherapy changed over time. Results: 18,513 patients were diagnosed with SCLC in our cohort. The median survival was 6 months for all patients, 1 year for those with limited stage and 4 months for extensive stage. 69% received chemotherapy and this proportion changed very slightly over time (test for trends p = 0.055). Age and performance status of patients remained stable over the study period, but the proportion of patients staged increased (p-value,0.001), mainly because of improved data completeness. There has been an increase in the proportion of patients that had a record of receiving both chemotherapy and radiotherapy each year (from 19% to 40% in limited and from 9% to 21% in extensive stage from 2004 to 2011). Patients who received chemotherapy with radiotherapy had better survival compared with any other treatment (HR 0.24, 95% CI 0.23–0.25). Conclusion: Since 2004, when the NLCA was established, the proportion of patients with SCLC having chemotherapy has remained static. We have found an upward trend in the proportion of patients receiving both chemotherapy and radiotherapy which corresponded to a better survival in this group, but as it only applied for a small proportion of patients, it was not enough to change the overall survival.
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spelling nottingham-337452020-05-04T16:42:55Z https://eprints.nottingham.ac.uk/33745/ Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit Khakwani, Aamir Rich, Anna L. Tata, Laila J. Powell, Helen A. Stanley, Rosamund A. Baldwin, David R. Hubbard, Richard B. Background: The purpose of this study was to identify trends in survival and chemotherapy use for individuals with smallcell lung cancer (SCLC) in England using the National Lung Cancer Audit (NLCA). Methods: We used data from the NLCA database to identify people with histologically proven SCLC from 2004–2011. We calculated the median survival by stage and assessed whether patient characteristics changed over time. We also assessed whether the proportion of patients with records of chemotherapy and/or radiotherapy changed over time. Results: 18,513 patients were diagnosed with SCLC in our cohort. The median survival was 6 months for all patients, 1 year for those with limited stage and 4 months for extensive stage. 69% received chemotherapy and this proportion changed very slightly over time (test for trends p = 0.055). Age and performance status of patients remained stable over the study period, but the proportion of patients staged increased (p-value,0.001), mainly because of improved data completeness. There has been an increase in the proportion of patients that had a record of receiving both chemotherapy and radiotherapy each year (from 19% to 40% in limited and from 9% to 21% in extensive stage from 2004 to 2011). Patients who received chemotherapy with radiotherapy had better survival compared with any other treatment (HR 0.24, 95% CI 0.23–0.25). Conclusion: Since 2004, when the NLCA was established, the proportion of patients with SCLC having chemotherapy has remained static. We have found an upward trend in the proportion of patients receiving both chemotherapy and radiotherapy which corresponded to a better survival in this group, but as it only applied for a small proportion of patients, it was not enough to change the overall survival. Public Library of Science 2014-02-21 Article PeerReviewed Khakwani, Aamir, Rich, Anna L., Tata, Laila J., Powell, Helen A., Stanley, Rosamund A., Baldwin, David R. and Hubbard, Richard B. (2014) Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit. PLoS ONE, 9 (2). e89426. ISSN 1932-6203 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0089426 10.1371/journal.pone.0089426 10.1371/journal.pone.0089426 10.1371/journal.pone.0089426
spellingShingle Khakwani, Aamir
Rich, Anna L.
Tata, Laila J.
Powell, Helen A.
Stanley, Rosamund A.
Baldwin, David R.
Hubbard, Richard B.
Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit
title Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit
title_full Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit
title_fullStr Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit
title_full_unstemmed Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit
title_short Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit
title_sort small-cell lung cancer in england: trends in survival and chemotherapy using the national lung cancer audit
url https://eprints.nottingham.ac.uk/33745/
https://eprints.nottingham.ac.uk/33745/
https://eprints.nottingham.ac.uk/33745/